For many children, their pediatrician has been a trusted constant in their lives since birth, healing sore throats and fixing boo-boos. But when your child no longer fits into the tiny chairs in the waiting room, it may be time to transition to a doctor who provides care for adults.
If a child’s doctor is a family medicine physician, then they don’t have to find a new provider, but some things still begin to change.
Think of the teen years as a practice run for your child managing their own healthcare, says UNC Health pediatrician Edward Pickens, MD. “It doesn’t have to be an abrupt transition, but it’s important for adolescents to start taking responsibility for their health.”
Parents, You May Wait in the Waiting Room
As a child gets older, their doctor will start spending at least part of most visits with them apart from Mom or Dad.
In many practices, personal electronic medical sites (including UNC MyChart) become the patient’s responsibility around age 13. Parents can access messages but can’t see all medical records or test results.
“The hope is that adolescents will become more involved in their own healthcare, being active participants instead of leaving it all up to their parent,” Dr. Pickens says.
Parents can facilitate this independence by encouraging their teens to schedule their own appointments or write down questions they want to ask their doctor.
Tender Teen Topics
There are some things most adolescents may not want to talk about in front of their parents, including sexual activity (current or future), sexual identity, substance abuse, use of tobacco, alcohol or vaping products, relationship safety, depression and anxiety.
Pediatricians also may have frank discussions with their growing patients about healthy lifestyles, eating well, sleeping enough, getting exercise and limiting screen time—topics many teens tune out when the advice comes from their parents.
“It’s imperative that we (doctors) build trust with our patients and show that we can keep things private,” Dr. Pickens says. “We want them to have someone they can talk to about things that will impact their health, potentially for the rest of their lives.”
Doctors are allowed to accept a minor’s consent for treatment of certain conditions, mostly involving sexual and mental health, though laws vary by state.
“Adolescence is a period of transitioning from your parents knowing everything about your life to your parents knowing what you want to tell them,” Dr. Pickens says. “It’s a normal and healthy part of growing up.”
Ask Your Pediatrician About Transitioning to Adult Care
There are no hard and fast rules for when a child must transition to an adult provider, but practices usually have their own standard procedures. For some, it’s age 18. For others, it’s age 21 or when the person has finished college. Most practices (general pediatricians or pediatric specialists) don’t accept new patients who are 18 or older, Dr. Pickens says. Make sure to ask your provider what you should expect and plan for.
By age 26, most individuals are required to provide their own health insurance and can no longer be listed as dependents on their parents’ policies (exceptions may be made for disabled children).
Chronic Conditions Can Make the Transition More Complicated
If a person is generally healthy without chronic conditions that need to be treated, the transition from pediatric to adult care is usually smooth, Dr. Pickens says. Physicians who routinely treat adults have more training and experience than pediatricians in conditions that affect adults but rarely children, like heart disease and high blood pressure.
Pediatricians have more training and experience in pediatric diseases and conditions, but some things impact a person for their entire lives, including congenital heart defects, autism, sickle cell disease, cystic fibrosis and neurological disorders.
For people with more complicated medical histories, Dr. Pickens and other pediatricians will talk to the adult provider to whom their patient is transitioning. He reminds his patients to give their new doctor time to get up to speed on their health conditions and to build a trusting relationship like the one between patient and pediatrician.
And while a patient may have mixed emotions about transitioning to a new doctor, the pediatrician also may be sad to see a patient go.
“I do have former patients who now bring their children to me,” Dr. Pickens says. “I always look forward to that.”
If you have questions about transitioning to an adult provider, talk to your pediatrician. If you need an adult doctor or a pediatrician, find one near you.